title: Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy.
abstract: OBJECTIVE
  Turner's syndrome (TS) is a rare genetic disorder caused by complete or partial X chromosome monosomy in a phenotypic female, and it is associated with increased morbidity and mortality for cardiovascular diseases, impaired glucose tolerance, and dyslipidemia.
  
  
  METHODS
  In 30 adult TS patients under chronic hormonal replacement therapy (HRT), 17β-estradiol (E(2)), body mass index (BMI), waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test (OGTT), 24 h ambulatory blood pressure monitoring (ABPM), and intima-media thickness (IMT) were evaluated and compared with those in 30 age- and sex-matched controls (CS).
  
  
  RESULTS
  No difference was found between TS and CS in E(2) and BMI, whereas waist circumference was higher (P<0.05) in TS (77.7±2.5 cm) than in CS (69.8±1.0 cm). Fasting glucose in TS and in CS was similar, whereas fasting insulin, HOMA index, and 2 h glucose after OGTT were higher (P<0.0005) in TS (13.2±0.8 mUI/l, 2.5±0.2, and 108.9±5.5 mg/dl respectively) than in CS (9.1±0.5 mUI/l, 1.8±0.1, and 94.5 ± 3.8 mg/dl respectively). Total cholesterol was higher (P<0.05) in TS (199.4 ± 6.6 mg/dl) than in CS (173.9±4.6 mg/dl), whereas no significant differences in high-density lipoprotein, low-density lipoprotein, and triglycerides were found between the two groups. In 13% of TS, ABPM showed arterial hypertension, whereas IMT was <0.9 mm in all TS and CS. A negative correlation between insulin levels, HOMA index, or 2 h glucose after OGTT and E(2) was present in TS.
  
  
  CONCLUSIONS
  Our results indicate that adult patients with TS under HRT are connoted by higher frequency of central obesity, insulin resistance, hypercholesterolemia, and hypertension.
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, 10126 Turin, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Giordano
authors.forename: Daniela
authors.initials: D
authors.lastname: Forno
authors.forename: Fabio
authors.initials: F
authors.lastname: Lanfranco
authors.forename: Chiara
authors.initials: C
authors.lastname: Manieri
authors.forename: Lucia
authors.initials: L
authors.lastname: Ghizzoni
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000378:metabolism*; D004958:Estradiol / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced / Q000378:metabolism; D006973:Hypertension / Q000139:chemically induced / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D009765:Obesity / Q000139:chemically induced / Q000378:metabolism; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000188:drug therapy* / Q000378:metabolism*; D055105:Waist Circumference / Q000187:drug effects / Q000502:physiology
chemical_list: D001786:Blood Glucose; D004958:Estradiol